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Experts question motives of mammogram guidelines

Jackboot said:
I know I sound like a broken record, but this is what happens when the government forces itself in to the free market. :shrug:
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And when the lawyers force their way into the free market of medicine, doctors order lots of diagnostic tests in order to cover their asses.
 
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MyOwnDrum said:
This just proves to me that a lot of doctors are ordering expensive diagnostics, most likely to cover their asses, and also because they are there and insurance will pay.
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It's called defensive medicine and it wastes tens of billions of dollars. It's a shame that none of the health care bills offered by the Democrats addresses this problem.

Mach said:
Between false positives, causing cancer, exacerbating existing cancer, biopsy risks, and no real help in terms of mortality (recalling news reports from memory here), it made sense to pull back on "suggested every year starting at 40".
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The report from the task force directly contradicts this.

The task force concluded that one cancer death is prevented for every 1,904 women age 40 to 49 who are screened for 10 years, compared with one death for every 1,339 women age 50 to 74, and one death for every 377 women age 60 to 69.
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It's a money saving measure... those who get breast cancer in their 40's won't be able to sue the government or these people who created these guidelines... so why not? This just goes to show, if this abortion of a health care bill gets passed more people will get health care, just not GOOD health care.
 
RightinNYC said:
The report from the task force directly contradicts this.
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No, it doesn't, beacuse the report does not discourge people from getting regular exams, it simply removes the federal guideline that it be every year with or without doctor/patient discussion on if it's necessary (it suggests something else, what...after 50 every other year or something like that).

Let's put it this way RightinNYC, right now the medical establishment allows millions of people to die every day because they are not doing routine examinations, full body MRIs, etc. It's not that you shouldn't do these things, or that they are not helpful, it's their status as a medical guideline from that agency, which has a whole host of other factors involved. We're still free to push our doctors for whatever we want to pay for, or listent to their advice, or get 3 opinions, or get 3 opinions + follow federal guidelines...or not.
 
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Mach said:
No, it doesn't, beacuse the report does not discourge people from getting regular exams, it simply removes the federal guideline that it be every year with or without doctor/patient discussion on if it's necessary (it suggests something else, what...after 50 every other year or something like that).

Let's put it this way RightinNYC, right now the medical establishment allows millions of people to die every day because they are not doing routine examinations, full body MRIs, etc. It's not that you shouldn't do these things, or that they are not helpful, it's their status as a medical guideline from that agency, which has a whole host of other factors involved. We're still free to push our doctors for whatever we want to pay for, or listent to their advice, or get 3 opinions, or get 3 opinions + follow federal guidelines...or not.
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The practical result of removing the federal guideline urging for mammograms starting at 40 is that insurance providers will stop covering mammograms starting at 40. That will result in fewer people having access to mammograms starting at 40, which will in turn lead to the marginally increased mortality rate that they referred to.
 
1069 said:
As far as I know, this recommendation has been in the works for some time.
For the past several years at least, there's been no consensus within the medical community on when mammograms should start.
There are a couple of issues here:

1. Each mammogram raises one's risk of cancer slightly.

2. Breast cancer under age 50 is rare.

3. Before menopause, mammograms are unlikely to detect cancer, because there is a lot of fibroid tissue in pre-menopausal breasts that makes it difficult if not impossible to detect tumors with a mammogram.

So, these ideas have been kicked around for some time. The debate has been going on for years.
I think a lot of experts in the field are now beginning to lean more toward routine mammograms only after age 50.
That does not mean no mammograms ever for women under 50.
It just means that it depends upon the circumstances.
For many women under 50, mammograms would be of little benefit, and the slight risk these women incurred from undergoing mammograms unnecessarily would not be justified.

I personally do not plan to have my first mammogram until I'm 50.
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i personally know three women who contracted breast cancer in the last 2 years....two under 50. i'm not so sure it's all that rare.
 
Aunt Spiker said:
There's no way to know, honestl y- if someone gets routine mammograms and is exposed to that radiation - and then later developes breast cancer - there *might* be a link or they're *might* not be a link.

I think it's such a delicate issue that the process of finding out for sure would be quite time consuming, challenging if at all possible - you're dealing with the unknowns. . .there's no way of telling the difference between some cancers caused by radiation and their naturally-occuring forms.

I think, then, that presuming that breast cancer might be caused by overexposure to that type of radiation is a safe medium.


Radiation Causes Breast Cancer by Stephanie Hiller
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there are many "knowns". age, weight, childbirth, onset of menses, breastfeeding history, genetics.

so, there is a way to tell the difference, at least theoretically.
 
1069 said:
Who GETS breast cancer more often?
Affluent white women. Read the national stats.
Who do you think is most likely to begin early routine mammograms?
Gee, I dunno... could it be affluent white women? :doh
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Please:roll: My dirt poor step mother would've been dead years ago if she didn't get checked in her 40's.
 
Hmml. I see a connection.
The majority of the heads of government bureaus and departments are affluent white males . . . and the majority of people with breast cancer are affluent white females.

So the government via husbanditis is the problem.

Cure = divorce.

*kidding!*
 
liblady said:
i personally know three women who contracted breast cancer in the last 2 years....two under 50. i'm not so sure it's all that rare.
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Of course it's not rare.


Breast cancer is the leading cause of cancer death among women ages 35 to 50

250,000 US women living with the disease are under the age of 40

Each year, almost 24,000 women under age 45 are diagnosed with breast cancer in the U.S. and almost 3,000 women under age 45 will die of the disease this year. Today there are more than 250,000 breast cancer survivors in the U.S. who were diagnosed at age 40 or younger.



I agree that's hardly rare.

Also interesting to note that women on Medicaid/Medicare have a higher mortality rate than women not on it. It was the same mortality rate as those without insurance.
 
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1069 said:
As far as I know, this recommendation has been in the works for some time.
For the past several years at least, there's been no consensus within the medical community on when mammograms should start.
There are a couple of issues here:

1. Each mammogram raises one's risk of cancer slightly.

2. Breast cancer under age 50 is rare.

3. Before menopause, mammograms are unlikely to detect cancer, because there is a lot of fibroid tissue in pre-menopausal breasts that makes it difficult if not impossible to detect tumors with a mammogram.

So, these ideas have been kicked around for some time. The debate has been going on for years.
I think a lot of experts in the field are now beginning to lean more toward routine mammograms only after age 50.
That does not mean no mammograms ever for women under 50.
It just means that it depends upon the circumstances.
For many women under 50, mammograms would be of little benefit, and the slight risk these women incurred from undergoing mammograms unnecessarily would not be justified.

I personally do not plan to have my first mammogram until I'm 50.
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For women UNDER 50, I offer a free and comprehensive molest...er....breast exam.
 
As I understand it this is not because of financial reasons. Nor is it because of the radiation, though it is true that for younger women (under 35) a mammogram poses more risk of giving cancer than it does of finding it.

The reason they changed this recommendation is that mammograms were finding something suspicious but harmless far more often than it did any good. This leads to thousands of surgeries and breast cancer treatments on women that turn out to be unnecessary. How many lives should be ruined to prolong one? You can say it saves lives but really, everybody dies eventually. Is it better to let one person live another 20 years or to put ten people through dangerous and unnecessary procedures, not to mention the psychological effects of thinking you have cancer. There is a similar situation with MRI body scans. They seem like a good idea but everyone has some anomaly somewhere that would never kill you but would have to be checked out anyways.

It seems like there should be a better way to reduce the problems without raising the risk. Why can't they simply be more careful interpreting the results? But given an either-or choice with no other options I think they made the right decision. But then again I don't have breasts.
 
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liblady said:
i personally know three women who contracted breast cancer in the last 2 years....two under 50. i'm not so sure it's all that rare.
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Maybe that's representative, maybe it's not. This is why we are forced to rely upon statistics. Unfortunately, statistics are also easy to manipulate/misinterpret, but correctly done give us a much better idea of what is going on in the aggregate than anecdotes.
 
rivrrat said:
Of course it's not rare.


Breast cancer is the leading cause of cancer death among women ages 35 to 50

250,000 US women living with the disease are under the age of 40

Each year, almost 24,000 women under age 45 are diagnosed with breast cancer in the U.S. and almost 3,000 women under age 45 will die of the disease this year. Today there are more than 250,000 breast cancer survivors in the U.S. who were diagnosed at age 40 or younger.

As for the rate of cancer in medicaid recipients: I would speculate there is correlation between low income and poor diet.



I agree that's hardly rare.

Also interesting to note that women on Medicaid/Medicare have a higher mortality rate than women not on it. It was the same mortality rate as those without insurance.
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My mother, aunt, and step mother had breast cancer. Three of my friends were treated for breast cancer this year (one age 40). None of these cancers were discovered by mammograms. In several cases -including my Mom- the lump was found about 9 months after the mammogram. It is anecdotal, certainly, but I have my doubts about the usefulness of yearly mammograms and I wonder if they enhance the likelihood of cancer occurring.

There are articles like this all over the internet:


In 1992 the Canadian National Breast Screening Study found that women in their 40s are actually more likely to die of breast cancer after they receive a decade of annual mammograms than women who do not start getting mammograms until after age 50. In September 2001, a British study by Dr. Gavin T. Royle and colleagues from the Southampton Breast Unit reported that doctors beat mammograms at detecting breast lumps without inflicting cancer-causing radiation into your breasts. The Southampton Breast Unit found that mammography was up to one-third less likely to detect lumps than were physicians. There should be no more debate. Mammography is a serious cancer liability. It should be called what it is: “Harmful and Obsolete.”



I don't know how credible they are but one thing I do know: Any physician who has been urging women to have yearly mammograms is unlikely to change their tune, now- admit that they may have been harming women? No way!
 
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Cassandra said:
My mother, aunt, and step mother had breast cancer. Three of my friends were treated for breast cancer this year (one age 40). None of these cancers were discovered by mammograms. In several cases -including my Mom- the lump was found about 9 months after the mammogram. It is anecdotal, certainly, but I have my doubts about the usefulness of yearly mammograms and I wonder if they enhance the likelihood of cancer occurring.

There are articles like this all over the internet:


In 1992 the Canadian National Breast Screening Study found that women in their 40s are actually more likely to die of breast cancer after they receive a decade of annual mammograms than women who do not start getting mammograms until after age 50. In September 2001, a British study by Dr. Gavin T. Royle and colleagues from the Southampton Breast Unit reported that doctors beat mammograms at detecting breast lumps without inflicting cancer-causing radiation into your breasts. The Southampton Breast Unit found that mammography was up to one-third less likely to detect lumps than were physicians. There should be no more debate. Mammography is a serious cancer liability. It should be called what it is: “Harmful and Obsolete.”



I don't know how credible they are but one thing I do know: Any physician who has been urging women to have yearly mammograms is unlikely to change their tune, now- admit that they may have been harming women? No way!
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Wow - scary. This whole conversation is so surreal to me. I finally just had my first mammo a week ago (normal). I did not start at 40, even tho my doc told me to. They kept scheduling appts for me at my annual physical, and I kept not going :3oops:
 
jackalope said:
Wow - scary. This whole conversation is so surreal to me. I finally just had my first mammo a week ago (normal). I did not start at 40, even tho my doc told me to. They kept scheduling appts for me at my annual physical, and I kept not going :3oops:
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Me too. Of course, with my family history this is a topic that concerns me. From what I can see, with the dangerous fast growing cancers, it is hit or miss with mammography.

Of course when people say that government pencil pushers should not get between you and your Doc I am reminded of the fact that Doctors prescribed horse piss estrogen for my Mom for 30 years and that is probably why she got cancer in the first place.
 
RightinNYC said:
Experts question motives of mammogram guidelines | Health | Reuters



I'm all for cutting back on care that isn't cost-efficient, but the timing of this move really does make you wonder whether the new guidelines were influenced by something other than science.
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No, it's motivated by science. Basically under 40, mammograms give as many false positives as it does real. So you have to ask how much money you're spending, and if you're actually measuring something real. For something that's worse t hat a 50/50 shot of the positive result being true, then I think you really have to raise an eyebrow as to how much you encourage this measurement technique. There are of course high risk women and women over 50 who should go and get these done. But basically the cancer society and others have said fine, maybe clarify the guidelines a bit more so that you are not discouraging discussion with doctors. Meanwhile, a better measuring device needs to be researched and created.
 
It's not just about the mammograms. They actually said women shouldn't be doing self-breast exams!!! That is patently INSANE.

Breast cancer is the leading cause of cancer death for women. The LEADING cause. Are some of you not getting this? And the government (and apparently some of you) are more worried about some false positives than actually catching the disease? How many false positives come out of pap smears? Quite a few I'd reckon since I've had several myself. But I would rather have 100 false positives than miss that ONE true positive.

They actually recommended that you don't do self-breast exams! Do you not see what this is going to snowball into? If and when - god forbid - we end up with a sad excuse for socialized healthcare, do you think they're going to pay for a biopsy of a lump you found yourself while doing an exam they told you NOT to do? Especially if you're under 50? Essentially 24,000 women a year will die.

They have decided that the costs of false positives outweigh the deaths of 24,000 women a year.
 
They, also, just adjusted the guidelines for pap-smears, too.

Yeah, it's absurd. (I know we were debating semantics ... but we seem to agree on this)
The gov needs to stay OUT of my medicine cabinet and OUT of our bedrooms . . . shoo shoo!

It's purely a personal decision - and if someone wants routine mammograms their insurance company should cover their alloted 50% or whatever they might cover - regardless of how many are done.
 
rivrrat said:
Breast cancer is the leading cause of cancer death for women. The LEADING cause.
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Prostrate cancer is the leading cancer death in men. Leading. It kills more people per year than breast cancer. Don't hear **** about it.

The point of this whom mammogram thing was to diagnose whether or not for a young age group if the procedure is efficient at finding cancer or not. It's not. Not for the younger age groups, barring specific high risk individuals. Should you not get it done? It's still up to you. No one is saying no, they're just saying there's damned decent chance it won't detect the cancer anyway. And if it detects something, there's a damned good chance it's not actually cancer. A more reliable method of detecting cancer needs to be created.
 
rivrrat said:
Breast cancer is the leading cause of cancer death for women. The LEADING cause. Are some of you not getting this? And the government (and apparently some of you) are more worried about some false positives than actually catching the disease? How many false positives come out of pap smears? Quite a few I'd reckon since I've had several myself. But I would rather have 100 false positives than miss that ONE true positive.
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Ikari said:
Prostrate cancer is the leading cancer death in men. Leading. It kills more people per year than breast cancer. Don't hear **** about it.
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Lung cancer is the leading cause of cancer death amongst both men and women (and heart disease is the leading cause of death for both, overall).

Breast cancer is the most commonly diagnosed cancer for women, and kills 24.4 per 100,000 women per year.
Prostate cancer is the most commonly diagnosed cancer for men, and kills 25.4 per 100,000 men per year.


Lung cancer is the most deadly, for men and women. Breast cancer and prostate cancer kill about the same about of women and men, respectively, each year.


Cancer – United States Cancer Statistics (USCS) – Facts and Major Findings – NPCR
 
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Aunt Spiker said:
They, also, just adjusted the guidelines for pap-smears, too.
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And for lung cancer and prostate cancer too, I think. I'm pretty sure that's what I heard.
 
jackalope said:
Lung cancer is the leading cause of cancer death amongst both men and women (and heart disease is the leading cause of death for both, overall).

Breast cancer is the most commonly diagnosed cancer for women, and kills 24.4 per 100,000 women per year.
Prostate cancer is the most commonly diagnosed cancer for men, and kills 25.4 per 100,000 men per year.


Lung cancer is the most deadly, for men and women. Breast cancer and prostate cancer kill about the same about of women and men, respectively, each year.


Cancer – United States Cancer Statistics (USCS) – Facts and Major Findings – NPCR
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I should have been more explicit:

Breast cancer is the leading cause of cancer death among women ages 35 to 50. (the very group of women that they are excluding from breast cancer screenings)
Breast Cancer Statistics
Mammograms cause breast cancer (and other cancer facts you probably never knew)
TransMed: Hereditary Breast Cancer
CDC - Women's Health - Facts and Stats - Selected U.S. National Research Findings - Cancer
 
So I guess they really aren't support "preventative" healthcare measure like they talked about so much.

But prayer's still imbursible! hoooah (sarcasm).
 
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